第九十六期:短时程脊髓电刺激治疗带状疱疹性神经痛的疗效观察
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短时程脊髓电刺激治疗带状疱疹性神经痛的疗效观察
作者:罗裕辉 熊东林 蒋劲等
临床单位:华中科技大学同济医学院附属协和医院麻醉科 广东医学院附属南山医院疼痛科

摘要
目的:
观察短时程脊髓电刺激治疗带状疱疹性神经痛的疗效。

方法: 选取101例带状疱疹性神经痛患者入组研究,通过经皮硬膜外植入电极进行短时程电刺激治疗。应用视觉模拟评分(visual analogue scale, VAS)评估不同时间点疗效,采用匹兹堡睡眠质量指数(pittsburgh sleep quality index, PSQI)评估睡眠质量,记录不同年龄组脊髓电刺激治疗周期并分析其相关性。

结果: 术前及术后1天、2天、3天、1周、1月、3月的VAS分别为7.53±1.88、3.44±1.24、2.20±1.42、1.67±1.11、1.12±0.89、1.00±0.77、0.79±0.71,术后疼痛明显缓解且不同时间点与术前VAS比较有统计学差异(P<0.001)。术前及术后1天、2天、3天、1周、1月、3月睡眠指数分别15.61±2.14、9.08±1.96、7.56±2.27、6.97±1.89、6.29±1.62、5.58±1.33、5.56±1.35, 睡眠质量明显改善,术后不同时间点与术前PSQI比较有统计学差异(P<0.001)。不同年龄段治疗周期存在波动但总体表现为随年龄增长呈向上趋势。

结论:短时程脊髓电刺激治疗可迅速降低患者疼痛,明显改善睡眠质量,从而有利于带状疱疹性神经痛转归。

EFFECTS OF SHORT-TERM SPINAL CORD STIMULATION FOR HERPETIC NEURALGIA
LUO Yu-Hui, XIONG Dong-Lin, JIANG Jin, et al.
Department of Anesthesia, Institute of Anesthesia and Critical Care, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology;
Affiliated Nanshan Hospital of Guangdong Medical College.

Abstract
Objective:
To observe the effects of short-term spinal cord stimulation (SCS) for acute herpetic neuralgia.

Methods: One hundred and one cases who suffered from herpetic neuralgia were treated with short-term spinal cord stimulation via transcutaneous epidural puncture approach. Visual analogue scale (VAS) was adapted to assess the effects at the different time of preoperation and postoperation 1 day, 2 days, 3 days, 1 week, 1 month and 3 months. Pittsburgh sleep quality index (PSQI) was applied to evaluate quality of sleep. Treatment period was recorded between the different aging subgroup.

Results: All patients underwent remarkably pain relief at different follow-up stages after SCS compared with the preoperation (P< 0.001). The VAS of preoperation and postoperation were 7.53±1.88, 3.44±1.24, 2.20±1.42, 1.67±1.11, 1.12±0.89, 1.00±0.77, 0.79±0.71, respectively. The PSQI of preoperation and postoperation were 15.61±2.14, 9.08±1.96, 7.56±2.27, 6.97±1.89, 6.29±1.62, 5.58±1.33, 5.56±1.35 respectively. Obviously, the quality of sleep at different follow-up stages were improved significantly after treatment (P<0.001). Although the curve of treatment period was slight fluctuation in an age-dependent manner, the tendency of it was arising with age.

Conclusion: Short-term spinal cord stimulation decreased the pain and imporved the quality of sleep for the herpetic neuralgia patients.

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